Interactive medical diagnosing with portable consumer devices

ABSTRACT

Medical tests and examinations are performed with consumer computing devices. The medical tests and examinations are selected and customized in accordance with conditions present in the testing environment, as well as physical characteristics of a user taking the test. The tests can include visual acuity tests, colorblindness tests and other medical tests, such as hearing tests.

CROSS-REFERENCE TO RELATED APPLICATIONS

Not applicable.

BACKGROUND

1. The Field of the Invention

This invention relates to systems, methods, and computer programproducts related to interactive medical testing and the diagnosis ofmedical conditions using portable consumer devices.

2. The Relevant Technology

Modern medical practices and technology have enriched and extended humanlife through the treatment of a variety of medical conditions Inherentin treating medical conditions is first detecting that those medicalconditions exist. While some medical conditions may be readilyascertainable, others may remain undetected absent affirmativediagnostic steps.

Many people are afflicted with medical conditions that cause degradedsensory input, such as medical conditions relating to vision and/orhearing. Because humans experience the world through sensory input, therelative quality of a person's sensory input is inherently subjective. Aperson may therefore have a medical condition causing degraded (ordegrading) sensory input while being unaware of the problem. As such,medical scientists have developed many objective tests designed tomeasure sensory input. The data from these tests can be used to diagnosewhich medical condition(s) are causing the deficiencies. Other medicalconditions unrelated to sensory input, may also be detected anddiagnosed through testing (e.g., blood tests, blood pressure testing,etc.). As such, medical testing, examination, and diagnosis have becomea standard part of modern life in recent decades.

Medical examination and diagnosis are generally carried out directly bymedical professionals (e.g., doctors, nurses, lab technicians, and thelike) at a hospital, doctor's office, or other medical facility.Accordingly, patients often have to travel to a medical establishmentfor follow-up testing to track the progress of treatment, or to detectfurther degradation or other changes related to the known condition.Even when people are unaware of any medical condition that needs to betreated, it is still common for such people to travel to a medicalestablishment to ascertain whether they have a medical condition basedon a suspicion that a medical condition may exist, or as a routineand/or proactive step to detect medical conditions as they arise.

Unfortunately, a trip to a medical facility can involve a significantinconvenience for patients and, sometimes, for medical professionals aswell. Patients, for example, suffer the inconvenience in terms of time(e.g., time to set up an appointment, time to drive to the medicalestablishment, time waiting at the medical establishment for the medicalprofessional to become available), money (e.g., money spent traveling,money paid to medical professionals and medical establishments, moneypaid to insurance, money unearned due to lost work time), and theinconvenience of having to arrange schedules around medicalprofessionals and family members who often have to drive or accompany anelderly patient.

For patients that are being tested merely on a suspicion that a medicalcondition may exist or as a preventative measure, this inconvenience canbe exasperated when no medical condition is found through the testing.For medical professionals, medical testing can be a distraction frommore important tasks, both in terms of attention directed to morecritical or productive medical tasks (e.g., continuing education,treatment of other patients), and in terms of attention directed to morelucrative activities.

Accordingly, there remains some room for further development in thefield of medical testing and diagnosis.

BRIEF SUMMARY

The present invention extends to methods, systems, and computer programproducts for conducting medical tests and examinations using computingdevices.

In one embodiment, a method for conducting a vision examination at aportable consumer device is performed by the patient. The methodincludes identifying and selecting one or more vision tests to performas part of the vision examination, based on consumer data. The method ofperforming the testing can also include identifying a viewing distancebetween a display of the portable consumer device and the user. Based onthe selected vision test(s), the portable consumer device presents theuser with visual test element(s) at the display, while adjusting atleast a visual size of the visual test element(s) based on theidentified viewing distance. The portable consumer device prompts theuser to identify at least one of the visual test element(s) and receivesuser input identifying an element. Based on the vision examinationresults, the portable consumer device identifies a visual acuity metric,a visual medical condition, a proposed visual treatment, and/or acorrective lens prescription.

In another embodiment, a method for conducting a colorblindness test ata portable consumer device is performed. This method includes, for atleast one colorblindness test, presenting the user with a multicolorimage that includes a multicolor pattern. The pattern illustrates avisually identifiable graphical element that is visually distinguishablewithin the multicolor pattern based on color. After prompting the userto identify the visually identifiable graphical element, the portableconsumer device receives user input at a touch-sensitive displayidentifying the at least one visually identifiable graphical element,and identifies whether or not a colorblindness condition may exist forthe user.

Embodiments of the invention also extend to other types of medicalexaminations, such as hearing examinations. As such, at least oneembodiment includes a method for conducting a hearing test at a portableconsumer device. The method includes presenting the user with an audioresponse user interface at a touch-sensitive display that prompts theuser to identify one or more audio characteristics of presented audioand, based on user input at the touch-sensitive display, calculating theuser's auditory sensitivity.

This Summary is not intended to identify key features or essentialfeatures of the claimed subject matter, nor is it intended to be used asan aid in determining the scope of the claimed subject matter.

Additional features and advantages of exemplary implementations of theinvention will be set forth in the description which follows, and inpart will be obvious from the description, or may be learned by thepractice of such exemplary implementations. The features and advantagesof such implementations may be realized and obtained by means of theinstruments and combinations particularly pointed out in the appendedclaims. These and other features will become more fully apparent fromthe following description and appended claims, or may be learned by thepractice of such exemplary implementations as set forth hereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS

In order to describe the manner in which the above-recited and otheradvantages and features of the invention can be obtained, a moreparticular description of the invention briefly described above will berendered by reference to specific embodiments thereof which areillustrated in the appended drawings. Understanding that these drawingsdepict only typical embodiments of the invention and are not thereforeto be considered to be limiting of its scope, the invention will bedescribed and explained with additional specificity and detail throughthe use of the accompanying drawings in which:

FIG. 1 illustrates a computer architecture that facilitates medicalexamination using computing devices;

FIG. 2 illustrates a flow chart of a method for conducting a visionexamination at a portable consumer device;

FIG. 3A illustrates a schematic diagram of configuring a viewingdistance based on a proximity sensor;

FIG. 3B illustrates a schematic diagram of configuring a viewingdistance based on one or more cameras;

FIG. 3C illustrates a schematic diagram of configuring a viewingdistance based on a known object and one or more cameras;

FIG. 4A illustrates a schematic diagram of one embodiment of a visualacuity test;

FIG. 4B illustrates a schematic diagram of one embodiment of a visualacuity test;

FIG. 4C illustrates a schematic diagram of one embodiment of a centervisual field test;

FIG. 4D illustrates a schematic diagram of one embodiment of aperipheral visual field test;

FIG. 4E illustrates a schematic diagram of one embodiment of acolorblindness test;

FIG. 4F illustrates a schematic diagram of one embodiment of acolorblindness test; and

FIG. 5 illustrates a user interface for educating a user about medicalanatomy and/or medical conditions.

DETAILED DESCRIPTION

The present invention extends to methods, systems, and computer programproducts for conducting medical tests and examinations using computingdevices.

Some embodiments include acts associated with conducting a visionexamination at a portable consumer device to test for nearsightedness orfarsightedness. Other embodiments involve performing colorblindnesstesting at a portable consumer device. In some embodiments, it is alsopossible to perform astigmatism testing.

Embodiments of the invention also extend to medical examinations forhearing or other conditions.

Computing Environment(s)

Embodiments of the present invention may comprise or utilize a specialpurpose or general-purpose computer including computer hardware, suchas, for example, one or more processors and system memory, as discussedin greater detail below. Embodiments within the scope of the presentinvention also include physical and other computer-readable media forcarrying or storing computer-executable instructions and/or datastructures. Such computer-readable media can be any available media thatcan be accessed by a general purpose or special purpose computer system.Computer-readable media that store computer-executable instructions arerecordable type storage media or other physical computer storage media(devices). Computer-readable media that carry computer-executableinstructions are transmission media. Thus, by way of example, and notlimitation, embodiments of the invention can comprise at least twodistinctly different kinds of computer-readable media: computer storagemedia (devices) and transmission media.

Computer storage media (devices) includes RAM, ROM, EEPROM, CD-ROM orother optical disk storage, magnetic disk storage or other magneticstorage devices, or any other medium which can be used to store desiredprogram code means in the form of computer-executable instructions ordata structures and which can be accessed by a general purpose orspecial purpose computer and which are recorded on one or morerecordable type medium (device).

A “network” is defined as one or more data links that enable thetransport of electronic data between computer systems and/or modulesand/or other electronic devices. When information is transferred orprovided over a network or another communications connection (eitherhardwired, wireless, or a combination of hardwired or wireless) to acomputer, the computer properly views the connection as a transmissionmedium. Transmissions media can include a network and/or data linkswhich can be used to carry or desired program code means in the form ofcomputer-executable instructions or data structures and which can beaccessed by a general purpose or special purpose computer. Combinationsof the above should also be included within the scope ofcomputer-readable media.

Further, upon reaching various computer system components, program codemeans in the form of computer-executable instructions or data structurescan be transferred automatically from transmission media to computerstorage media (devices) (or vice versa). For example,computer-executable instructions or data structures received over anetwork or data link can be buffered in RAM within a network interfacemodule (e.g., a “NIC”), and then eventually transferred to computersystem RAM and/or to less volatile computer storage media (devices) at acomputer system. Thus, it should be understood that computer storagemedia (devices) can be included in computer system components that also(or even primarily) utilize transmission media.

Computer-executable instructions comprise, for example, instructions anddata which, when executed at a processor, cause a general purposecomputer, special purpose computer, or special purpose processing deviceto perform a certain function or group of functions. The computerexecutable instructions may be, for example, binaries, intermediateformat instructions such as assembly language, or even source code.Although the subject matter has been described in language specific tostructural features and/or methodological acts, it is to be understoodthat the subject matter defined in the appended claims is notnecessarily limited to the described features or acts described above.Rather, the described features and acts are disclosed as example formsof implementing the claims.

Those skilled in the art will appreciate that the invention may bepracticed in network computing environments with many types of computersystem configurations, including, personal computers, desktop computers,laptop/notebook computers, message processors, hand-held devices,multi-processor systems, microprocessor-based or programmable consumerelectronics, network PCs, minicomputers, mainframe computers, tablets,mobile telephones, PDAs, pagers, routers, switches, and the like. Theinvention may also be practiced in distributed system environments wherelocal and remote computer systems, which are linked (either by hardwireddata links, wireless data links, or by a combination of hardwired andwireless data links) through a network, both perform tasks. In adistributed system environment, program modules may be located in bothlocal and remote memory storage devices.

In particular, one or more embodiments of the invention may be practicedwith portable consumer computing devices. Portable consumer computingdevices or more simply, portable consumer devices, can be any of a broadrange of computing devices designed or optimized for portability and forpersonal use. Portable consumer devices can take a variety of forms,ranging from more traditional notebook and netbook computers to anemerging and rapidly growing market of handheld devices, including smartphones (e.g., the APPLE IPHONE, ANDROID phones, WINDOWS phones, SYMBIANphones), tablet computers (e.g., the APPLE IPAD, ANDROID tablets),gaming devices (e.g., NINTENDO or PLAYSTATION portable gaming devices,the APPLE IPOD), multimedia devices (e.g., the APPLE IPOD), andcombinations thereof. Many of these devices can enable richuser-interactivity by including combinations of output, input, and othersensory devices, such as touch- or pressure-sensitive displays (usingcapacitive or resistive technologies, for example), still and videocameras, Global Positioning System (GPS) receivers, magnetic compasses,gyroscopes, accelerometers, light sensors, proximity sensors,microphones, speakers, etc. These devices can also comprise a variety ofcommunications devices, such as combinations of cellular modems (e.g.,Global System for Mobile Communications (GSM), Code division multipleaccess (CDMA)), Wireless Fidelity (Wi-Fi) radios, Bluetooth radios, NearField Communication (NFC) devices, etc. Many portable consumer devicesare expandable, such that a user can add new hardware and functionalitynot present during manufacture of the device. It will be appreciatedthat as the market for portable consumer devices expands and develops,the functionality of these devices will also expand to utilize new andimproved user-interaction devices and communications devices. Theembodiments described herein are expansive and can also utilize anyfuture developments in the field of portable consumer devices.

Medical Diagnosing Methods And Systems

In recent years, self-testing and self-examination for the diagnosis ofmedical conditions has become increasingly popular as an alternative totraveling to medical establishments, particularly with the rise of theInternet and the accompanying flood of information. However, theseself-diagnosis tests, which are often designed and/or carried outwithout professional guidance or expert knowledge, are frequentlyfraught with inaccuracies resulting from a consumer performing the testincorrectly and/or from interpreting the results incorrectly. As aresult, self-testing and self-examination can lead to a false-positive“detection” of medical conditions that does not actually exist and whichcan, in turn, lead to unnecessary treatment and/or waste of limitedmedical resources. Conversely, a false-negative “diagnosis” of an actualmedical condition can lead to the medical condition remaining untreatedand such that it can worsen.

Embodiments of the present invention can be used to help improve theforegoing state of medical testing, particularly self-testing, byproviding rich, interactive medical testing environments throughcomputing devices, such as portable consumer devices which are linked toprofessional systems.

The disclosed testing environments facilitate self-testing orself-examination in a manner that can eliminate much of the inaccuracyin testing and diagnosing with conventional methods and can reduce muchof the inconvenience associated with traveling to a medical facility toreceive specialized testing. For example, while some of the disclosedembodiments allow individuals to conduct self-examinations (eliminatingthe need for the individual to travel to a medical professional), thetests can be designed, overseen, and/or tracked by medical professionalswith professional systems that are linked to the consumer devices thatare utilized to perform point of service testing. Furthermore, bycalibrating particular tests to particular test subjects and testingenvironments, and by utilizing interactive capabilities of portableconsumer devices, the disclosed embodiments can reduce, or eveneliminate, inaccuracies that can be introduced by a patient performingaspects of a self-test. In fact, some embodiments will be found toprovide a level of testing accuracy and effectiveness approximatingin-person visits conducted by medical professionals, and without theunwanted time, travel and scheduling inconveniences described above.Embodiments of the invention also provide for combinations of medicaltracking, medical diagnosis, consumer education, medical referrals,and/or medical advice.

FIG. 1 illustrates an example computer architecture or environment 100that facilitates medical examination using computing devices, such asportable consumer devices. Referring to FIG. 1, computer architecture100 can include a medical examination system 101 and a clearinghouse105, which can be connected to one another via a network 104, such as,for example, a Local Area Network (“LAN”), a Wide Area Network (“WAN”),and even the Internet. Accordingly, each of the depictedsystems/components as well as any other connected computer systems andtheir components, can create message related data and exchange messagerelated data (e.g., Internet Protocol (“IP”) datagrams and other higherlayer protocols that utilize IP datagrams, such as, Transmission ControlProtocol (“TCP”), Hypertext Transfer Protocol (“HTTP”), Simple MailTransfer Protocol (“SMTP”), etc.) over the network 104. Computerarchitecture 100 can include any number of medical examination systems,such as the additionally illustrated medical examination systems 102 and103, which can communicate with one another and/or the clearinghouse 105via the network 104 or any other appropriate local or alternativecommunications mechanism (e.g., BLUETOOTH, Infrared). Each of theillustrated systems can also comprise a standalone system or adistributed system.

Each medical examination system (e.g., examination system 101), whichmay, in some implementations, be embodied in a portable consumer device,can be configured with a plurality of components that facilitateadministration of one or more medical examinations to a user (not shown)of the examination system. Examination system 101, for example, caninclude an input component 106, a selection component 107, aconfiguration component 108, a presentation component 109, an analysiscomponent 110, and a storage component 111. As indicated by the ellipses113, the examination system 101 can include any number of components,and can include many different arrangements of components while stillfalling within the scope of this disclosure. Similarly, theclearinghouse 105 can be configured with one or more correspondingcomponents, including a storage component 112.

Referring to examination system 101, the storage component 111 can beconfigured to store a variety of data (i.e., metadata) that facilitatesadministration of medical examinations, including information forconducting one or more medical tests that are part of one or moremedical examinations. The stored examination/testing information cancover a broad range of medical topics, such as one to more vision teststhat are part of a vision examination, one or more hearing tests thatare part of a hearing examination, psychological tests/examinations,blood tests/examinations, etc.

The storage component 111 can also store information concerning one ormore users of the examination system 101 including any applicablemedical history information, such as past treatment information, pasttesting/examination results, information about treating physiciansand/or treatment facilities used by the user, prescription information(e.g., visual prescription information, drug information), and the like.The storage component 111 can also store information concerning userpreferences, a configuration of one or more medical tests, an identityof a medical clearinghouse (e.g., clearinghouse 105), or any otherinformation that may be useful for conducting and tracking medicaltesting.

Turning briefly to the clearinghouse 105, the storage component 112 ofthe clearinghouse 105 can, similar to the storage component 111 ofexamination system 101, also store a variety of data that facilitatesadministration of medical tests/examinations. This information caninclude all or some of the information stored in the storagecomponent(s) 111 of one or more examination systems. As such, storagecomponent 112 can store medical test/examination information, medicalhistory information, configuration information, and the like. Whereasstorage component 111 would typically store information primarily forusers of the corresponding examination system, the storage component 112at the clearinghouse 105 may store information applicable to users of aplurality of examination systems (e.g., information for any combinationof examination systems 101, 102, 103, or any other examination systems).The storage component 112 can thus store all or part of testinginformation that is usable by a plurality of examination systems.Storage component 112 can also store preference data for differentmedical professionals and insurance information related to services andproducts that are utilized by or referenced during any of the medicaltesting described herein.

In this manner, the clearinghouse 105 can provide central management fora variety of information types. In one or more embodiments, forinstance, the clearinghouse 105 can provide a central repository formedical tests and examinations, and then distribute thesetests/examinations to individual examination systems. The clearinghouse105 can also facilitate the development of new tests/examinations or theimprovement of existing tests/examinations. In one or more additionalembodiments, the clearinghouse 105 can comprise or be linked to one ormore medical databases used by medical professionals. The clearinghouse105 can thus be used by medical professionals to remotely administermedical examinations through the examination systems, or can be used byusers at the examination systems to submit results of medicalexaminations to medical professionals for analysis. Furthermore, theclearinghouse 105 can track the history of medical examinations, whichcan be made accessible to users and medical professionals alike. Theclearinghouse 105 can also submit or initiate the submission ofinsurance claim processing for any testing performed.

Returning to the components of examination system 101, input component106 can be configured to receive sensory and user input in a variety offorms, and to pass that input to any other appropriate component. Userinput can comprise input expressly provided to the examination system100 by a user, and may take the form of audible (i.e., spoken) input,touch input, typewritten input, pointing device input, motion detection,etc. By contrast, sensory input can comprise environment informationsensed by the examination system 101 with or without express actiontaken by the user to provide the input, and may take the form ofpositional input (e.g., compass, GPS, gyroscope, accelerometer),proximal input (e.g., from a proximity sensor), visual input (e.g., froma still or video camera, or a light sensor or detector), audible input(e.g., ambient noise), etc. Input component 106 can also be configuredto receive specialized medical input, such as through specializedmedical hardware included at the examination system 101 as integratedhardware or as one or more add-on devices. For instance, input component106 can be configured to receive input from hardware designed for bloodand/or blood pressure analysis, temperature analysis, urine analysis,breath analysis, etc. Input component 106 can also be configured toreceive data separately obtained from external sensory devices.

Selection component 107 is configured to receive instructions to conducta medical examination, and to select one or more appropriate tests toperform as part of the examination. For example, selection component 107can be configured to receive user input (e.g., via input component 106)at the examination system 101, the user input selecting a type ofmedical examination (e.g., a vision examination) to perform and/or inresponse to questionnaire data about a user's current medical state.Based on the user input, the selection component 107 can select one ormore tests (e.g., particular visual acuity tests, particular colorvision tests) to perform as part of the selected examination. Theselection of tests can also be performed automatically based on apredefined or scheduled testing interval set by the user or a medicalprofessional as well as other factors, such as medical histories of theuser, preferences of the medical professional, capabilities of the userdevices and/or other factors.

Selection component 107 can also be configured to receive instructionsto conduct a medical examination from other sources as well. Forinstance, a physician may remotely request that a medical examination beperformed via the clearinghouse 105. In addition, a medical examinationmay be initiated based on dynamic factors detected by the examinationsystem 101 (e.g., consumer device). For instance, the examination system101 may detect that a particular user has trouble entering input at theexamination system 101 (or at another computing system), and mayinitiate a vision examination as a result (e.g., the examination system101 may detect that the user mistypes characters, clicks on or touchesgraphical elements inaccurately, exhibits a slow reaction time, and thelike). As another example, the examination system 101 may detect that auser chooses a volume setting that is abnormally high, and may initiatea hearing examination. In some embodiments, the examination system 101can consider contextual factors, such as ambient noise, whether the useris using head phones, the particular acoustic properties of the audiohardware in use, the particular properties of the audio being produced,etc. Thus, the selection component 107 can intelligently suggest a usertake a medical examination based on detected factors, and canpotentially identify that the user has a medical condition for which theuser may not otherwise test.

The selection of particular tests can involve retrieving any applicableinformation from storage component 111 (and/or from clearinghouse 105),such as available tests for the examination type, the user's pasttesting history, any applicable medical conditions the user is known tohave, applicable prescription information (e.g., corrective lensprescriptions), physician's notes/recommendations, etc. Based on theinformation retrieved, the selection component 107 can select one ormore tests that are tailored for the particular user requesting theexamination. As such, the selection component 107 can focus the selectedexamination by presenting tests that are most relevant for the userrequesting the examination, and can eliminate any testing which may beless relevant. Furthermore, the selection component 107 can choose anoptimal order and/or starting point in the tests based on the accessedinformation.

Configuration component 108 can calibrate and configure the examinationsystem 101 for accurate test administration automatically and/or inresponse to user input. In one embodiment, configuration component 108can calibrate one or more tests based on physical characteristics of theuser. For instance, the configuration component 108 may obtain physicalinformation about the user from storage component 111 and/orclearinghouse 105, or from express user input. The physical informationcan include any relevant physical information for the types oftests/examinations being conducted. For instance, in the context ofvision examination, the physical information may include whether or notthe user is currently wearing corrective lenses and if so, theprescription of the lenses. Similarly, in the context of a hearingexamination, the physical information may include whether or not theuser is currently wearing an assistive hearing device, and itsconfiguration. The configuration component 108 can then use thisuser-provided information to configure/calibrate any tests asappropriate.

In another embodiment, the configuration component 108 can calibrate oneor more tests based on physical characteristics of the examinationsystem and/or an environment in which the examination system 101resides. The configuration component 108 can obtain any relevantphysical characteristic information from the storage component 111 orvia the input component 106 from the user or from one or more sensorydevices. In the context of a vision examination, for instance, theconfiguration component 108 may prompt the user to enter an approximatedistance between a display at the examination system 101 and the user'sface, or may prompt the user to enter the general lighting conditions atthe testing location (e.g., daylight, tungsten lighting, fluorescentlighting, bright, dim, etc.). Additionally or alternatively, theconfiguration component 108 may use one or more sensory devices alone orin combination with user input, to ascertain the desired physicalcharacteristic(s) and environmental information automatically withcamera devices or other sensors.

Presentation component 109 is configured to present medical examinationsto users, using tests selected by selection component 107 and configuredaccording to configuration component 108. The particular manner in whichtests are presented can vary depending on the type of test/examinationbegin administered. Some non-limiting examples are provided below.Presentation component can also be used in connection with selectioncomponent 107 and configuration component 108 during selection oftests/examinations and configuration of these examinations. Presentationcomponent 109 can leverage many user- and environmental-interactivefeatures of the examination system 101 to optimize the examinationprocess, making examinations user-friendly, accurate, and comprehensive.For instance, presentation component 109 can leverage speakers andmicrophones for providing instructions and prompts and for receivinguser feedback. Presentation component 109 can also utilize touch orpressure-sensitive display technologies to provide a rich and accurateuser-interactive experience. Similarly, existing image and light-sensingtechnologies can be utilized to facilitate the processing of user andenvironmental input.

Analysis component 110 is configured to analyze results for administeredtests, and to take any appropriate action based on the results. Forinstance, analysis component 110 can generate a testing score (e.g.,visual acuity level, detectable audible ranges, blood sugar levels, andso forth) and output the score to the user. Analysis component 110 canalso record/track results of any administered tests/examinations,including any computed scores, using local storage (e.g., storagecomponent 111) or remote storage (e.g., storage component 112 atclearinghouse 105). Analysis component 110 can also submit results tomedical professionals for additional analysis, and potentially presentthe professional analysis to the user.

In some embodiments, the medical examination system 101 includesfunctionality for presenting users with interactive anatomicalrepresentations of human physiology, for presenting users with medicalconditions related to represented anatomical regions, for educating theusers, and for referring users to medical specialists. Thus, based onresults of testing, one or more of the analysis component 110 or amedical professional may diagnose a probable medical condition, and useone or more interactive anatomical representations to educate the userabout the medical condition and to refer the user to a specialist. Insome embodiments, a medical professional is in live/remote communicationwith the user during the testing and can interact with the user throughthe medical examination system of the user via a connected medicalexamination system of the medical professional.

Some embodiments of the invention will now be described in the contextof a visual examination. It will be appreciated, however, that thedisclosed embodiments are applicable to a broad range of medicalexaminations, and that these examples should not be construed aslimiting the applicability of the disclosed embodiments. For example, atleast some of the disclosed embodiments may also be applicable totesting and/or tracking one or more of hearing, blood pressure, blood(e.g., diabetes), urine, breath, etc.

Visual Examinations

FIG. 2 illustrates a flow chart of an example method 200 for conductinga vision examination at a portable consumer device (e.g., medicalexamination system 101). Method 200 will be described with respect tothe components and data of computer architecture 100.

Method 200 includes an act of receiving user input requesting a visionexamination (act 201). For example, input component 106 can receiveexpress user input requesting that a vision examination be conducted.Alternatively, the request for a test can automatically result fromdetected conditions (e.g., user input errors, slow response times),predefined or dynamic schedules, a request from a physician, etc.

In response to receiving user input to request the vision examination,method 200 includes an act of identifying one or more vision tests toperform as part of the vision examination (act 202). For example,selection component 107 can use express user input (e.g., selection of avisual acuity test or a color blindness test, specification of acorrective lens prescription, specification of a medical condition),locally stored information (e.g., local medical history information,past testing results), and/or remotely stored information (e.g.,physician's notes, new/updated tests, remote medical historyinformation) to select one or more tests to perform as part of thevision examination. Selection component 107 can, for instance, selectone or more visual acuity tests (e.g., Snellen charts or similar tests),visual field tests (e.g., Amsler grids or similar tests, peripheralvision tests), color vision tests, eye shape mapping (astigmatismtesting), and so forth etc. Selection component 107 can also select anoptimal order and/or starting point in the test(s).

Identification of an appropriate test can also be based on profile dataassociated with a user. Accordingly, some embodiments of the inventionutilize facial recognition technologies to identify a user and to matchan appropriate test to that user, based on the user's stored profiledata. Login data, device ownership data, or other identificationinformation can also be used to access user profile data that can beused to help facilitate the selection of an appropriate test for aparticular user.

Facial recognition technologies utilizing camera elements on theconsumer device can also be used to identify a user and to match anappropriate test to a corresponding user profile. Login data, deviceownership data, or other identification information can also be used toaccess user profile data that can be used to help facilitate theselection of an appropriate test for a particular user.

Method 200 also includes an act of configuring the vision examination(act 203). Configuration of the vision examination can includeconfiguring or modifying the tests that make up the vision examinationbased on one or more of physical characteristics of the user (e.g.,whether the user is wearing glasses, the user's corrective lensprescription), physical characteristics of the portable consumer device,environmental information, physician requirements, etc. This informationcan be obtained automatically, based on camera detection technologies,and/or can be entered manually.

For instance, act 203 can include identifying a viewing distance betweena display of a portable consumer device and the user, which is then usedto adjust visual characteristics, such as size, of one or more testelements, when displayed, or to adjust camera zoom properties whentaking pictures of the eye for astigmatism mappings.

Identifying the viewing distance can involve configuration component 107receiving user input from the user and/or retrieving stored physicalcharacteristic information. For instance, identifying the viewingdistance can comprise prompting the user to expressly enter anapproximate viewing distance between the user's face and the display.Additionally or alternatively, identifying the viewing distance cancomprise querying the user for physical characteristic information aboutthe user, such as the user's arm length or sleeve length, which can beused to approximate the viewing distance when the portable consumerdevice is held at arm's length. One will appreciate that combinations ofother physical characteristics, such as age, build/body type, race,gender, height, “wing span,” etc. can be used to approximate the viewingdistance based on average human proportions (e.g., based on measuredstatistical results, based on the “golden ratio”).

Identifying the viewing distance can additionally or alternativelyinvolve using sensory devices at the portable consumer device. Forinstance, as illustrated in FIGS. 3A-3C, the configuration component 107can compute the viewing distance between the display and the user's faceusing a variety of sensory devices. The illustrated embodiments are forillustration only, and are in no way limiting to the ways for computingthe viewing distance using sensory devices

In the embodiment of FIG. 3A, for example, the portable consumer device308 can include a proximity sensor 301 that detects the viewing distance304 between the portable consumer device 308 and the user's face 302.The proximity sensor 301 can use any appropriate proximity detectionmechanism, such as one that actively emits a detection signal, includingsound waves and/or electromagnetic waves (e.g., radio waves, laserlight, infrared light), and computes the viewing distance 304 based on areflection of the emitted signal. Use of a proximity sensor 301 canenable dynamic measurements of the viewing distance 304 if the distancechanges during the vision examination (e.g., if the user does not keepthe portable consumer device 308 at a consistent position relative tothe user's face).

Additionally or alternatively, in the embodiment of FIG. 3B, theportable consumer device 308 can include one or more cameras 303. In oneor more embodiments, with camera(s) 303 the configuration component 107can detect the viewing distance 304 automatically (e.g., based on facialdetection technology that detects the user's face 302 and thatcalculates the viewing distance 304 based on the apparent size of theviewer's face), or with additional input from the user (e.g., input thatsupplies additional physical characteristic information about the userthat can be used to estimate the size of the user's head, such as age,gender, race, weight, build/body type, hat size, etc.). In one or morealternative embodiments, the configuration component 107 can display asilhouette or outline 305 of a face/head on the display, along with anoverlay of a dynamically-captured image of the user's face 302. The usercan then adjust one or more settings at the portable consumer device 308and/or reposition the portable consumer device 308 so that the user'sface 302 is aligned with the silhouette or outline 305. Theconfiguration component 107 can then compute the viewing distance 304based on any supplied settings, any supplied physical characteristicinformation, and the alignment of the user's face 302 with thesilhouette or outline 305. This embodiment can be useful to ensure theportable device is positioned at a proper distance/alignment prior toselecting and performing the test.

In yet another embodiment shown in FIG. 3C, the configuration component107 can prompt the user use an object 306 having a known size (e.g., aUnited States quarter) to configure the viewing distance 304. Forinstance, the user can be prompted to hold the object 306 near (e.g.,beside or in front of) his or her face, and the configuration component107 can use one or more cameras 303 to detect a relative size/distanceof the object 306 and, by extension, the user's face 302. Alternatively,the user can be prompted to hold the object 306 in front of his or herline of sight to the display (e.g., one or two inches in front of aneye) and adjust the location of the portable consumer device 308 untilthe object 306 appears (from the perspective of the user) to be the samesize as a displayed graphical element 307. Based on a known size of theobject 306 and a known display size of the graphical element 307, theconfiguration component 107 can compute the viewing distance 304 (orensure that the user positions the portable consumer device 308 at aknown viewing distance 304).

In yet another embodiment, the user can be prompted to position thedevice near the user's face and then to move the device to a desireddistance away from the user's face. The device can track relativemovement and corresponding distance from the user, which remainsstationary. The user can also provide input that defines a measureddistance between the device and the user position for the test.

In addition to identifying a viewing distance, act 203 can includeidentifying any other appropriate environmental information. Forexample, the portable consumer device 308 can include one or more lightsensors that detect the brightness and/or other characteristics of thelighting in the testing environment (e.g., color temperature, whitepoint, and so forth). Based on this information, the configurationcomponent 107 can configure one or more visual elements (e.g., displaybrightness, display contrast, color space, white point) of the visionexamination to provide an optimal visual test given the particulartesting environment.

After identifying and configuring vision tests for the visionexamination, method 200 includes an act of conducting the visionexamination (act 204). Conducting the vision examination can include thepresentation component 109 visually presenting the user with one or morevisual tests while adjusting the test(s) as configured, prompting theuser to interact with the tests, and receiving appropriate user input.Visually presenting the user with one or more visual tests can involvepresenting a variety of test types using a variety of interactivemechanisms. The embodiments of FIGS. 4A-4E, for instance, illustratesome non-limiting examples of some possible visual tests.

FIG. 4A illustrates an embodiment of a visual acuity test that uses aSnellen chart (e.g., rows of variably-sized letters), or a similartesting method. As illustrated, the portable consumer device can displayall or a portion of a visual test that includes visual test elements(e.g., letters, numbers, figures, etc.). When displaying the visual testelement(s), the portable consumer device can adjust one or more visualcharacteristics of at least one test element, such as size, boldness,contrast, etc. based on configuration performed by the configurationcomponent 108. For instance, as indicated by the arrows 401, the size ofone or more visual test elements displayed as part of a Snellen chartmay be adjusted based on the viewing distance 304. The portable consumerdevice can then prompt the user to identify one or more of the visualtest elements. The portable consumer device may, for example, prompt theuser via an audible prompt to select a particular letter in the chart(e.g., an audible prompt to touch the letter ‘Z’ while viewing with aparticular eye, as shown). Alternatively, the portable consumer devicemay prompt the user identify one or more visual test elements via anaudible response (e.g., a prompt to read the second line of thedisplayed letters while viewing with the right eye). In such a case, theprompting may take the form of an audible prompt or a visual prompt(e.g., by highlighting the requested row using one or more colors, bydrawing a box around the row, by using arrows or other indicators, etc.)Test presentation can involve presenting differing tests to each eye,which improves on more traditional static testing in which a user maymemorize the chart being used. It will be appreciated that while theportable consumer device is illustrated as displaying a plurality ofletters in a “traditional” Snellen chart manner, the interactive natureof portable consumer devices can enable richly interactive testingmethodologies using menus, panning/zooming, multiple display screens,etc.

For instance, FIG. 4B illustrates an alternative embodiment in which theportable consumer device conducts a visual acuity test using a series ofdisplay screens. In a first screen 402, the portable consumer device candisplay to the user one or more visual test elements, which can be drawnaccording to a test metric and environmental conditions (e.g., lighting,viewing distance). Thus, in the first screen 402, the visual testelements may be sized/drawn in a manner designed to ascertain the user'svisual acuity. In a second screen 403 the portable consumer device canprompt the user to identify the visual test element(s) displayed in thefirst screen. In the second screen 403, the prompt can include itemsthat are readily identifiable regardless of the user's visualcapabilities (e.g., using bolding, using large font sizes, coupling thedisplayed items with an audio prompt, etc.). Alternatively, the portableconsumer device can prompt the user to provide responses audibly. Timingfor alternating between the various screens can be predetermined orselected by a user or medical professional. In some embodiments, thetiming progressively changes and gets faster as the test continues overtime.

Other visual acuity testing methodologies are also possible, includinguse of static menus, popup menus, prompting the user to reduce theviewing distance until the visual test elements become legible, etc.FIGS. 4A and 4B therefore illustrate just a few of the interactivemethodologies that are possible when performing visual acuity testingusing portable consumer devices.

In other embodiments, test elements (e.g., letters, shapes or otherobjects) are dynamically resized or modified over time until a useridentifies that he or she can recognize them. For instance, the contrastof the display can progressively increase from a low contrast to a highcontrast over time, after initially being displayed, until the usercorrectly identifies the displayed element(s). The size of an object canalso start small and progressively get larger, with or without changingthe contrast and/or color scheme of the object, over time, until a userresponds with input that correctly identifies the object. This data canbe analyzed and used with other test data to facilitate diagnosis ofpossible medical states and conditions of a user.

FIG. 4C illustrates an embodiment of conducting a central visual fieldtest using an Amsler grid, or a similar testing method. As shown, theportable consumer device can display a pattern designed to detectconditions affecting a person's central visual field, such as maculardegeneration or epiretinal membrane. Similar to the visual acuitytesting, the exact nature of the displayed test pattern (e.g., number ofgrid lines, spacing of grid lines, boldness of pattern), which mayinclude any number of colors, can vary based on acquired information(e.g., physical characteristics of the user, ambient lighting, viewingdistance). After displaying the test pattern the portable consumerdevice can prompt the user to view the pattern in a prescribed manner(e.g., to look at a central dot using one or more eyes) and to touch anyareas in the pattern (e.g., areas 404 and 405) that appear to the userto be distorted. Based on the selected areas, the portable consumerdevice can make an approximation as to the viewer's central visual fieldcapabilities.

FIG. 4D illustrates an embodiment of conducting a peripheral visualfield test. Here, the portable consumer device can leverage sensorydevices, such as one or more cameras 406 to track the user's movements.Thus, the portable consumer device can prompt the user to move atraceable object 407 (such as the user's hand) about the user's field ofvision while looking at the portable consumer device. The portableconsumer device can also prompt the user to indicate (e.g., audible orvia touch interaction with the portable consumer device) when thetractable object 407 moves out of the user's peripheral range of vision.Using the one or more cameras 406, the portable consumer device candetermine a location of the traceable object 407 relative to the user'speripheral range of vision. Peripheral vision tests can be conducted inother ways as well. In one embodiment, for example, the user is promptedto direct his or her eyes forward and then move the portable consumerdevice, itself, through the user's range of vision. The portableconsumer device can then determine the user's range of vision using avariety of sensors (e.g., cameras, accelerometers, gyroscopes,compasses, etc.) that measure the position of the portable consumerdevice relative to the user's head. The user can also be tested on theidentification of objects displayed on the device when the device ispositioned at different offset angles from the user's direct line ofsight. Instructions received from the device can be rendered to the useruntil the device is positioned properly, relative to the user, for thetesting.

FIGS. 4E-4F illustrate embodiments for conducting a colorblindness test.As shown, the portable consumer device can display a pattern of colorsdesigned to test the user's ability to differentiate certain colors. Inthe illustrated example, for instance, the portable consumer devicedisplays a pattern of colors which, if properly differentiated by theuser's eyes, reveal one or more test items (shapes, in this case). Muchlike the other tests previously described, the displayed pattern ofcolors can be calibrated based on characteristics of the user and theenvironment (e.g., a detected ambient lighting condition can be used toalter the colors displayed at the portable consumer device for optimalclarity). The user can then be prompted to identify the displayed testitems, which can be shapes, figures, words, letters, numbers (such asshown in FIG. 4F), etc. The user can respond in a variety of manners,such as by interactively tracing the test item(s), as shown in FIG. 4E.Responses can also include audible responses (e.g., “square, triangle,and circle”), typewritten responses, selection from menus, etc.

Accordingly, as illustrated in the examples of FIGS. 4A-4F, the act 204of conducting a vision examination can include a variety of visiontests, which can be administered in a variety of interactive manners. Itwill be appreciated that the calibration of the tests and the recordingof results of the tests by the portable consumer device can greatlyincrease the accuracy of the tests.

Notably, the input received from a user during the application of a testcan include any combination of audible and touch input. In someembodiments, the input is passed on in real-time to a professional thatis remotely connected to the portable device of the user through one ormore network connections.

Concurrent with or subsequent to testing, method 200 can also include anact of analyzing results of the vision examination (act 205). Forinstance, analysis component 110 can analyze results of one or morevision tests as they are being conducted, and can dynamically adapt thetests based on the analysis (e.g., to add additional tests or modifyexisting tests to focus the testing or to gain more testing data, toremove tests when sufficient testing data has been obtained, etc.).Alternatively, the analysis component 110 can analyze results of one ormore vision tests after completion. Regardless of when the analysiscomponent 110 performs the analysis, the analysis component 110 canperform one or more analysis steps, such as computing testingresults/scores (e.g., a visual acuity metric), formulating a diagnosisof a condition, proposing a treatment, tracking results, formulating acorrective lens prescription, reporting results to medicalprofessionals, recommending a specialist, educating the user aboutmedical anatomy and conditions, receiving input from a professional tomodify a test during or after application of a test, etc.

FIG. 5 illustrates an exemplary user interface for educating the userabout medical anatomy and/or medical conditions. In particular, FIG. 5illustrates an interactive user interface, in accordance with one ormore embodiments, for educating the user about the anatomy of a humaneye. As shown, the user interface can include an anatomicalrepresentation 501 of an eye as well as controls fornavigating/manipulating the anatomical representation 501. For instance,the user may rotate and zoom the anatomical representation 501 throughdirect touch or pointer device interaction with the anatomicalrepresentation 501. Additionally or alternatively, the user may use acontrol dialogue 502 to modify displayed information. The controldialogue 502 can include, for instance, motion options that define how amotion control 503 responsively manipulates/moves the anatomicalrepresentation 501, when actuated by a user touching or otherwiseinteracting with the control dialogue 502, such as through verbalcommands.

The control dialogue 502 can also include one more options toenable/disable annotations, one or more options to add/remove anatomicallayers to the anatomical representation 501, etc. Thus, the analysiscomponent 110 and use interactive user interface of FIG. 5 to educatethe user about the human eye, and to help the user gain a greaterunderstanding about the tests being administered. The interactive userinterface of FIG. 5 can also include any number of additional elementsfor educating the user about specifically-diagnosed conditions,including interactive anatomical representations of the conditions;text, photos, videos, and/or illustrations describing the conditions;text, photos, videos and/or illustrations describing treatments,condition-specific annotations; etc.

Other Testing

As indicated, the disclosed embodiments are applicable to far more thanvision examinations. For example, the disclosed embodiments can alsoprovide a rich environment for conducting hearing examinations. Muchlike a vision examination, selection of a hearing examination can beginat the express request of a user or medical professional, as a result ofa static or dynamic schedule, or due to detected hearing deficiencies(e.g., using a high volume setting), etc. Selection of hearing tests toperform as part of the examination can also be based on input from auser, accessed metadata, or detected conditions. For instance, the aportable consumer device can access the user's past testing history,physician recommendations, the user's past music listening history(along with volume levels), the user's age, race, and gender, etc.

In some embodiments, the user is prompted to take a test when volumelevels are detected to be set or beyond certain thresholds for apredetermined duration of time.

Once one or more hearing tests have been selected, the portable consumerdevice can configure the hearing tests in any appropriate manner. Forinstance the portable consumer device can detect the ambient noise inthe testing environment using one or more microphones, can detectacoustic characteristics of the audio hardware being used, etc. Theportable consumer device can then configure the hearing test(s)accordingly.

The portable consumer device can then present the hearing test(s) to theuser, while prompting for feedback and recording results. The rich userinput features of portable consumer devices can provide a significantimprovement over conventional testing techniques. For instance, whereastraditional hearing tests typically collect data such as “do you hearthe current sound being played?”, a rich user interface at the portableconsumer device can enable much more dynamic input. In one or moreembodiments, the user interface, which may include separate controls foreach ear, can include one or more controls for recording the user'sperception of many characteristics of any sound being presented,including for example loudness, pitch, fidelity, etc. These controls mayinclude buttons, sliders, menus, lists, etc. In some embodiments, theuser interface can include one or more multi-touch interface elements(e.g., sliders) that can enable to user to provide dynamic feedbackabout the audio being presented to each ear.

During analysis, the portable consumer device can also educate the userabout hearing anatomy and conditions, track results, submit results tomedical professionals, make referrals, etc. In addition, the portableconsumer device can make recommendations about audio hardware optimizedfor the user's hearing capabilities, recommend assistive hearing devicesand their configuration, configure audio characteristics of the portableconsumer device (e.g., volume settings, equalizer settings) to provideoptimal audio quality for the user based on results of the testing,configure maximum volume limits to protect the user's hearing, etc.

Accordingly, the embodiments disclosed herein provide methods, systems,and computer program products for conducting medical examinations oncomputing devices, such as portable consumer devices. Some exemplarymedical examinations may include vision and hearing testing, but thescope of the embodiments disclosed herein extend to many forms oftesting, such as blood, blood pressure, urine, etc.

The present invention may be embodied in other specific forms withoutdeparting from its spirit or essential characteristics. The describedembodiments are to be considered in all respects only as illustrativeand not restrictive. The scope of the invention is, therefore, indicatedby the appended claims rather than by the foregoing description. Allchanges which come within the meaning and range of equivalency of theclaims are to be embraced within their scope.

We claim:
 1. A computer-implemented method for conducting a visionexamination at a portable consumer device, the method comprising: an actof the portable consumer device receiving an instruction from a remotecomputer system, the remote computer system being configured to enableone or more medical professionals to remotely administer vision teststhrough the portable consumer device, the instruction instructing theportable consumer device to perform a vision examination, theinstruction being initiated by a particular medical professional at theremote computer system; based at least in part on receiving theinstruction, an act of the portable consumer device identifying one ormore vision tests to perform as part of the vision examination; an actof the portable consumer device identifying a viewing conditionassociated with a display of the portable consumer device; for at leastone of the one or more vision tests, the portable consumer device:presenting the user with one or more visual test elements at the displayof the portable consumer device, while adjusting at least a visualproperty of the one or more visual test elements based on the identifiedviewing condition; prompting the user to identify at least one of thevisual test elements; and receiving user input identifying the at leastone of the visual test elements; and an act of the portable consumerdevice sending one or more results of the one or more vision tests tothe remote computer system for analysis by the particular medicalprofessional.
 2. The method of claim 1, wherein the act of the portableconsumer device identifying one or more vision tests to perform as partof the vision examination comprises identifying the one or more visiontests based on one or more of: metadata obtained locally at the portableconsumer device, or metadata obtained from the remote computer system.3. The method of claim 2, wherein the metadata comprises one or more of:medical history information, prior vision examination information, orcorrective lens prescription information.
 4. The method of claim 1,wherein the act of the portable consumer device identifying one or morevision tests to perform as part of the vision examination comprisesidentifying the one or more vision tests based on user-supplied visioninformation.
 5. The method of claim 1, wherein the act of the portableconsumer device identifying one or more vision tests to perform as partof the vision examination comprises selecting a point in at least one ofthe one or more vision tests based on one or more of stored metadata oruser-supplied vision information.
 6. The method of claim 1, wherein themethod includes the portable consumer device identifying a viewingdistance between a display at the portable consumer device and the userin response to user input expressly identifying a viewing distance. 7.The method of claim 1, wherein the method includes the portable consumerdevice identifying a viewing distance between a display at the portableconsumer device and the user by: using a proximity sensor to calculatethe viewing distance; using one or more cameras to calculate the viewingdistance based on facial recognition; or using one or more cameras tocalculate the viewing distance based on recognition of an object havinga known size.
 8. The method of claim 1, wherein the display propertyincludes at least a size of the one or more visual test elements andwherein the size of the one or more visual elements is adjusted based onthe identified viewing distance by scaling a relative size of the one ormore visual test elements so that the one or more visual test elementshave a particular apparent visual size from the perspective of the user,regardless of the identified viewing distance.
 9. The method of claim 1,wherein at least one of the one or more vision tests comprises an Amslergrid test, the method further comprising: presenting the user with anAmsler grid at the display of the portable consumer device, whileadjusting one or more of a number of grid lines in the Amsler grid or aspacing between grid lines in the Amsler grid, based on the identifiedviewing distance, wherein the display of the portable consumer devicecomprises a touch-sensitive display; and prompting the user to touch oneor more points at the display of the portable consumer devicecorresponding to points on the Amsler grid that appear distorted; andreceiving user input identifying one or more points at the display ofthe portable consumer device on the Amsler grid that appear distorted.10. The method of claim 1, wherein the at least one of the one or morevision tests comprises a visual acuity test, the method furthercomprising: presenting the user with one or more visual test elements atthe display of the portable consumer device corresponding to one or morecharacters of a Snellen chart, while adjusting at least a size of theone or more characters based on the identified viewing distance;prompting the user to identify at least one of the one or morecharacters; and receiving user input identifying the at least one of theone or more characters.
 11. The method of claim 10, wherein promptingthe user to identify at least one of the one or more characterscomprises prompting the user audibly.
 12. The method of claim 10,wherein the display of the portable consumer device comprises atouch-sensitive display, and wherein prompting the user to identify atleast one of the one or more characters comprises prompting the user totouch at least one of the one or more characters on the touch-sensitivedisplay.
 13. The method of claim 10, wherein receiving user inputidentifying the at least one of the one or more characters comprisesreceiving the user input audibly.
 14. The method of claim 1, wherein theinstruction includes the one or more vision tests.
 15. The method ofclaim 1, wherein the instruction instructs the portable consumer deviceto obtain the one or more vision tests from the remote computer system.16. The method of claim 1, wherein the portable consumer deviceparticipates in a live connection with a computer system associated withthe particular medical professional during administration of the visionexamination, enabling the particular medical professional to be in liveremote communication with the user through the portable consumer deviceduring administration of the vision examination by the portable consumerdevice.
 17. A computer program product comprising one or more hardwarestorage devices having stored thereon computer-executable instructionsthat, when executed by one or more processors of portable consumerdevice, cause the portable consumer device to conduct a visionexamination, including at least the following: receiving an instructionfrom a remote computer system, the remote computer system beingconfigured to enable one or more medical professionals to remotelyadminister vision tests through the portable consumer device, theinstruction instructing the portable consumer device to perform a visionexamination, the instruction being initiated by a particular medicalprofessional at the remote computer system; based at least in part onreceiving the instruction, identifying one or more vision tests toperform as part of the vision examination; identifying a viewingcondition associated with a display of the portable consumer device; forat least one of the one or more vision tests: presenting the user withone or more visual test elements at the display of the portable consumerdevice, while adjusting at least a visual property of the one or morevisual test elements based on the identified viewing condition;prompting the user to identify at least one of the visual test elements;and receiving user input identifying the at least one of the visual testelements; and sending one or more results of the one or more visiontests to the remote computer system for analysis by the particularmedical professional.
 18. A computer system, comprising: a clearinghousecomputer system that is configured to enable one or more medicalprofessionals to remotely administer vision tests through one or moreportable consumer devices; and a particular portable consumer device,the particular portable consumer device being configured to conduct avision examination, including being configured to perform at least thefollowing: receive an instruction from the clearinghouse, theinstruction instructing the particular portable consumer device toperform a vision examination, the instruction being initiated by aparticular medical professional at the clearinghouse computer system;based at least in part on receiving the instruction, identify one ormore vision tests to perform as part of the vision examination; identifya viewing condition associated with a display of the particular portableconsumer device; for at least one of the one or more vision tests:present the user with one or more visual test elements at the display ofthe particular portable consumer device, while adjusting at least avisual property of the one or more visual test elements based on theidentified viewing condition; prompt the user to identify at least oneof the visual test elements; and receive user input identifying the atleast one of the visual test elements; and send one or more results ofthe one or more vision tests to the clearinghouse computer system foranalysis by the particular medical professional.
 19. The computer systemof claim 18, wherein the clearinghouse computer system is configured totrack a history of vision examinations for the user, including storingthe one or more results of the one or more vision tests.
 20. Thecomputer system of claim 18, wherein the clearinghouse computer systemis configured to initiate submission of insurance claim processing basedon conducting the one or more vision tests.